Apparatus and method for retracting and viewing bodily tissues on remote display device

ABSTRACT

A reactor device for simultaneously retracting and viewing bodily tissues during a medical procedure. The retractor includes a blade member for retracting bodily tissues and an imaging device to form an image of the bodily tissues which are exposed by the operation of the blade member. The imaging device is coupled to a display device so that the image of the bodily tissues formed by the imaging device is displayed by the display device. Moreover, a method is provided for endoscopically performing a tissue retracting procedure using a retractor device. The method includes the steps of retracting bodily tissues using a retractor to form a cavity and imaging the cavity using an imaging device mounted on said retractor to form an image of the cavity and to provide the image of the cavity to a display device that is coupled to the imaging device.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a surgical implement, and moreparticularly, to a surgical implement used to simultaneously retract andview bodily tissues. Even more particularly, the invention relates to anendoscopic retractor equipped with an imaging unit to form images ofbodily tissues which are exposed from operation of the endoscopicretractor.

2. Description of the Related Art

Many surgical procedures done today typically include the use of anendoscopic device to aid surgeons and medical staff to visualize bodilytissues exposed during a surgical procedure. An endoscopic procedure mayeven be carried out to merely view bodily tissues (e.g., a colonoscopy).Basically, an endoscope is inserted through the skin of a patient into aprepared opening in the body which is typically called a cavity. Thecavity is often filled with air or other gasses to expand the cavity forbetter viewing. See U.S. Pat. No. 4,608,965 to Anspach, Jr., et. al. The'965 patent teaches an endoscope retainer that does not slip out of acavity and also retracts soft tissue around the opening in the cavityaway from the cavity to provide a better view of the cavity.

Typically, the endoscopes of the type contemplated herein, include aprobe part which is inserted into an bodily organ. Generally, the probepart includes a charge coupled device (CCD) on its end to form images ofthe object of interest (e.g., a heart or other bodily organ), anilluminating member such as light channel to supply light to the objectof interest, a lens though which the CCD captures a reflection of thelight illuminated by the illuminating member from the object of interestand a receiving channel member to receive and transmit the electricsignals produced by the CCD to a main system which converts the electricsignals into image signals (e.g., NTSC signals or other signals whichare displayable on a television tube device or on another type ofcathode ray device--e.g., a computer terminal screen). See e.g., U.S.Pat. No. 4,872,446 to Nudelman et al. The '446 patent, in particular,discloses a probe carrying a single fiber optics channel including aflexible coherent fiber optics bundle for both transmitting illuminationlight and receiving reflected light from the object. An endoscope ofsuch a configuration can be used in very small diameter applications,such as those required in the imaging of coronary arteries.

Procedures currently being done with an endoscope include gall bladdersurgery, knee surgery, hernia surgery, insertion of breast implantsthrough a long tube through the navel, brow lift surgery, and colonresection. Additionally, OB/GYN surgeons have been using endoscopy formany years to treat various problems of the pelvic area. Orthopedicsurgeons use endoscopic procedures to treat and access joint cavities.

The benefits which result from using an endoscope are not, however,available to all types of medical procedures. This is because manyprocedures that exist today and that require a relatively small openingof the skin of a subject to allow for direct visualization and/orinsertion of implantable material are not being done endoscopically dueto the impracticality of current technologies. For example in breastaugmentation in women, an incision of approximately 3 to 4 centimeters(cm) is made under a women's breast. Through this relatively smallincision, a relatively large implant needs to be inserted into an evenlarger pocket, which pocket needs to be created through the smallincision. To help facilitate this type of procedure, there are currentlyavailable lighted retractors. See e.g., U.S. Pat. No. 4,226,228 to Shinet al. and U.S. Pat. No. 5,035,232 to Lutze et al.

Generally, a retractor is a hand-held rod-like structure which is curvedin such a way as to allow a surgeon to pull tissue away from an incisionin order to open the incision to provide for direct visualization of theoperative sight or location. A surgeon may more easily visualize thepocket with a lighted retractor of the type contemplated above. However,problems still exist when visualizing deep pockets. For example, theoperating surgeon often must contort her body and neck in order tostrain to see the depths of the wound made by a relatively smallincision. A surgeon often encounters similar problems when doing facelifts, particularly in the area of the neck.

U.S. Pat. No. 5,039,198 to VanBeek attempts to alleviate some of theproblems mentioned above with a stereoscopic microsurgery system. In thesystem of the '198 patent, a head mounted viewing assembly, includingdual optical viewers, is used for depth of field viewing of an operativesight or location. Problematically, however, the system of the '198patent is bulky and inconvenient to use and it does not provide a clearand complete view of the operative site as would and imaging device ofthe type used in endoscopes.

SUMMARY OF THE INVENTION

In view of the foregoing and other problems associated with the art towhich the present invention relates, it is therefore an object of thepresent invention to solve such problems.

It is yet a further object of the present invention to provide asurgical implement for easily and clearly visualizing a bodily cavityformed through a relatively small opening in a skin surface.

It is still another object of the present invention to provide a singlesurgical implement for simultaneously performing a minimal openingtissue retracting procedure and providing endoscopic visualization of apocket formed through a relatively small incision made as a result ofthe minimal opening procedure.

It is yet a further object of the present invention to provide a singlesurgical implement for performing a minimal opening tissue retractingprocedure, simultaneously providing endoscopic visualization of a deeppocket formed through a relatively small incision made by the minimalopening procedure and also simultaneously providing suction to evacuatesmoke and other matter (e.g., gasses or liquids) which are produced byan electrocautery device.

It is still a further object of the present invention to enableassistants of an operating surgeon to easily and clearly visualize anoperative site while the surgeon performs a tissue retracting procedure.

It is still another object of the present invention to facilitateteaching a tissue retracting procedure.

It is still a further object of the present invention to reduce thenumber of instruments, and therefore the number of hands, required toperform a given surgical procedure.

These and other objects of the present invention are achieved byproviding a retractor device for simultaneously retracting and viewingbodily tissues during a medical procedure. The retractor includes ablade member for retracting bodily tissues and an imaging device to forman image of the bodily tissues which are exposed from operation of theblade member. The imaging device is coupled to a display device so thatthe image of the bodily tissues is displayed thereby.

Moreover, the present invention provides a method for endoscopicallyperforming a tissue retracting procedure using a retractor device. Themethod includes the steps of retracting bodily tissues using a retractordevice to form a cavity and imaging the cavity using an imaging devicemounted on said retractor to form an image of the cavity and to providethe image of the cavity to a display device that is coupled to theimaging device.

BRIEF DESCRIPTION OF THE DRAWINGS

The above-listed and other features and advantages of the presentinvention will become apparent and readily appreciated from thefollowing detailed description of the preferred embodiments, taken inconjunction with the attached drawing figures, of which like elementsare represented by like reference numerals and of which:

FIG. 1 is a top view of an endo-retracting device according to a firstembodiment of the present invention;

FIG. 2 is a cross-sectional view of the endo-retracting device of FIG. 1taken along the line 2--2;

FIG. 3 is a cross-sectional view of the endo-retracting device of FIG. 1taken along the line 3--3.

FIG. 4 illustrates a modification to the endo-retracting device of FIG.1.

FIG. 5 illustrates a further modification to the endo-retracting deviceof FIG. 1.

FIG. 6 is a top view of an endo-retracting device according to a secondembodiment of the present invention;

FIG. 7 illustrates a modification of the second embodiment depicted inFIG. 6.

FIG. 8 is a top view of a suction-retracting device according to a thirdembodiment of the present invention;

FIG. 9 illustrates an example of an alternative configuration of theretracting devices of the first, second and third embodiments depictedin FIGS. 1-8; and

FIG. 10 illustrates a fourth embodiment according to the presentinvention which employs a wireless signal transmission system.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The present invention is now described with regard to the exemplaryembodiments shown in FIGS. 1-10. Like parts will be referred to withlike reference numerals where appropriate within the drawings.

Referring now to FIG. 1, a preferred embodiment of a surgical implementin accordance with the present invention is designated generally by thereference numeral 10. Surgical implement 10 includes handle 12, shaft14, blade 16 and endoscope 18. Elements 12, 14 and 16 form aconventional retractor of various configurations. With reference to FIG.9, therein shown is an example of an alternative configuration of aconventional retractor 200 including elements 12, 14, and 16. Inparticular, endoscope 18 includes scope (i.e. probe) 20, fiber-opticsbundle 22 disposed within fiber-optics channel 24 and standardinterfacing equipment 26 for receiving and processing signals from thefiber-optics bundle and displaying an image based on the received andprocessed signals under the display device of the interfacing equipment.

Shaft 14 has a first end portion 28 and a second end portion 30. Handle12 is rigidly and integrally formed with shaft 14 at first end portion28. Blade 16 is rigidly and integrally formed with shaft 14 at secondend portion 30. Retracting elements 12, 14 and 16 are preferably madefrom a rigid material such as metal, but may be made from othermaterials such as hard plastics, rubber or the like. All that isrequired of the material from which retracting elements 12, 14 and 16are formed is that such material be suited to surgical uses.

Endoscope 18 is shown as being encased with a strong plastic or metalmaterial to withstand sterilization techniques, i.e., an autoclave,along with retractor elements 12, 14 and 16. Endoscope 18 may bedisconnected from equipment 26 at approximately 32 for sterilization andstorage. Scope 20 is insertable into a body cavity along with blade 16and a top surface 46 of scope 20 is approximately even with a topsurface 48 of blade 16. Scope 20 has a conventional internalconfiguration, such as that disclosed in the Nudelman et al. or theMurata patent as such were mentioned above. That is, referring now toFIG. 2, which illustrates a cross sectional view taking along the line2--2 of FIG. 1, scope 20 includes a signal fiber-optics channel 24containing fiber-optics bundle 22, as disclosed in Nudelman et al.

It should be noted that with regard to the embodiment shown in FIG. 1and with regard to the other embodiments discussed herein, that theendoscope part of the retractor device is configured to form images ofbodily tissues. In particular, the endoscope should be configured togenerate electrical signals which can be processed to form image orvideo signals for display on a display device. For example, an endoscopecan be used which generates television (TV) signals which can beprocessed in conventional ways to be displayed on a television set ormonitor. For a discussion of the use of cameras and fiber-optic bundlesto achieve the video-optical characteristics of the endoscope and itsfeatures of the present invention, the reader is directed to theabove-mentioned Nudelman et al. patent (U.S. Pat. No. 5,109,276).Additionally, it should be noted that the signals generated by theendoscope structure of the present invention can be digitally processedto aid in visualizing special image characteristics and like (e.g.,visually detecting radioactive coloring agents in bodily tissues). Suchdigital processing techniques for television and video signals aregenerally discussed in R. H. Stafford, DIGITAL TELEVISION (BandwidthReduction and Communication Aspects), John Wiley & Sons Press, Copyright1980.

With reference now to FIG. 3 on the other hand, which illustrates across-sectional view taking along the line 3--3 of FIG. 1, scope 20includes at least one illuminating channel 34 and a receiving channel 36including a lens (not shown) and a CCD device (not shown) fortransmitting light reflected from an object, as disclosed in Murata.

Referring again to FIG. 1, endoscope 18 is arranged along either side(the opposite side illustrated by broken lines) of retractor elements12, 14 and 16, along the longitudinal direction of the retractorelements. Endoscope 18 is securely adhered to the retractor elementsalong surface 38 (or surface 40) with conventional bonding techniquessuch as glue. Instead, endoscope 18 may be securely connected to theretractor elements with conventional connecting elements such a screwsor clamps (not shown). Similarly, endoscope 18 may be adhered orconnected to a top surface 42 (see FIG. 4) or a bottom surface 44 (seeFIG. 5) of the retractor elements. Referring again to FIGS. 1, 2 and 3,surgical implement 10 may further include a suction tube 50 locatedwithin endoscope 18, to simultaneously evacuate smoke produced by anelectrocautery device while retracting tissue with implement 10.

FIG. 1 further shows a knob or joystick 52 attached to the endoscopenear the handle, to allow the surgeon to control a rotation of scope 20to adjustably visualize the entire cavity while gripping handle 12 andretracting tissue. See e.g., the Murata patent which teaches a controlknob for controlling vertical and horizontal movements of a head portionof a probe. See also, U.S. Pat. No. 5,159,466 to Hibino et al., whichteaches a distal end of the endoscope provided with a bendable portion.Moreover, the Hibino et al. patent teaches both a knob for manuallyoperating the bendable portion and a joystick for vertically andhorizontally bending the bendable portion in conjunction with a motor.The Hibino et al. patent also teaches a straight switch forstraightening the bendable portion and a vibration switch for minutelyvibrating the bendable portion.

With reference now to FIG. 6, therein illustrated is a second embodimentof a surgical implement 100 of the present invention. In thisembodiment, endoscope 18 is located within hollow portion 54 of theretractor elements 12, 14 and 16. Hollow portion 54 runs through handle12, shaft 14 and blade 16. Endoscope 18 fits securely within hollowportion 54 and includes the same channel(s) as illustrated in eitherFIGS. 2 or 3. Top surface 46 of the scope is aligned with the topsurface 48 of blade 16. Top surface 46 of blade 16 is either transparentto allow imaging by scope 20 or has an aperture of width X equal to thewidth of scope 20 or the width of channel 54, to allow imaging by scope20. FIG. 7 shows scope 20 slightly above top surface 48 of blade 16,such that scope 20 protrudes slightly from aperture X. The surgicalimplement 100 of the embodiment shown in FIG. 6, as well as themodification to second embodiment shown in FIG. 7, may further includeknob/joystick 52, attached to an outer surface of handle 12 andinternally to endoscope 18 to control a movement of probe 20 asdiscussed above with regard to the first preferred embodiment. Asfurthest discussed above, implement 100 of FIGS. 6 and 7 mayadditionally include a suction channel and illuminating channel withinendoscope 18.

With reference now to FIG. 8, therein depicted is a third embodiment ofa surgical implement, in accordance with the present invention and isdesignated generally by reference numeral 100. Similar to the embodimentof FIG. 1, surgical implement 100 includes handle 112, shaft 114, blade116 and suction channel 50. Elements 12, 14 and 16 form a conventionalretractor of various configurations. Suction channel 150 may beconnected to either side of the retractor elements, similar to theendoscope of FIG. 1, or may be connected on either the top or bottomsurface of the retractor elements, similar to the endoscope of FIGS. 4and 5. The retractor is a conventional lighter retractor in combinationwith a suction device. Alternatively, suction channel 150 may be locatedwithin the hollow portion 54 of the retractor, similar to the endoscopeof FIG. 6, with the hollow portion also including a conventionalillumination channel. The embodiment of FIG. 8 illustrates a hand heldretractor and a suction device to facilitate the suction of smoke of atissue retraction operation that a accumulates in a large pocket with asmall opening.

Referring now to FIG. 10, therein depicted is yet another embodiment ofthe present invention. For the most part, this embodiment is exactly thesame as the embodiment depicted in FIG. 1. However, the embodimentdepicted in FIG. 10 employs commonly used and understood wirelesstransmission technology to transmit a video or other signal(s) from atransmitter 200 located on surgical implement 10 to correspondingreceiver 201. The signals transmitted by transmitter 200 and which arereceived by receiver 201 can processed by interfacing equipment 26 anddisplayed in a conventional manner. For example, if the transmitter 200is configured to process a video signal of the television variety (i.e.,a raster type signal which originates from detections by a CCD typedevice and which are converted to an NTSC signal) such a signal may thenbe transmitted by well-known and used FM radio transmission devices toreceiver 201 for processing so that interface equipment 26 can displaythe same in a conventional way. A typical wireless video signaltransmission system comprising a transmitter for processing a videosignal to produce an FM radio broadcast in the FM radio range of about900 Mhz which can be received by a corresponding radio receiver is onemanufactured by RECOTON Corporation having Model No. V900SX. The V900SXsystem is designed so that a video source (e.g., a NTSC video source)connects to a transmitter which transmits FM broadcasts at either 914 or922 Mhz and which are received by receiver which is typically connectedto a video signal display device (e.g., a television set or monitor).

It is believed that the use of such wireless systems within the contextof the present invention and, in particular, the embodiment depicted inFIG. 10, will now allow surgeons to effectively use an endo-scopicretracting device without having to be burdened with messy wire andcable arrangements which are typically referred to a "spaghetti wires."That is, the embodiment depicted in FIG. 10 will now allow surgeons tohave a single, hand-held endo-scopic retracting device which is free ofany tethering device such as a cable which connects the device to adisplay system. The details of coupling a radio or other wireless signaltransmitter to a corresponding radio or wireless signal receiver in thecontext of the present invention will be readily appreciated by thoseskilled in the art of wireless signal transmission systems. Moreover,while enabling disclosure has been provided with reference to FM orradio based transmission systems, other forms of wireless transmissionsystems (e.g., Infra-Red, etc.) can be employed. Finally, it should benoted that in the case of the embodiment depicted in FIG. 10, powersystems such as batteries or the like would need to be maintained withinimplement 10 so as to provide operational energy to the components ofthe imaging system and the signal transmission system; such power andbattery systems, especially in the field of medical devices, are wellknown to those skilled in the art of medical electronic devices.

Although a few preferred embodiments of the invention have been shownand described, it will be readily appreciated by those skilled in theart that many changes and modifications may be made to such embodimentswithout departing from the principles and spirit and scope of thepresent invention, the scope of which is defined in the appended claims.

What is claimed is:
 1. A device for endoscopically performing a tissueretracting procedure including a retractor having a handle connected toa shaft connected to a blade to retract tissue, said device comprising:asolid-state image sensor device connected to a retractor, to captureimages of tissue being retracted by said retractor and a body cavityformed by said retractor and to output a corresponding signal; and aremote display device connected to said solid-state image sensor device,to display said images based on said signal.
 2. The device as claimed inclaim 1, further comprising a knob connected to said solid-state imagesensor device and said retractor, to adjustably control a movement ofsaid solid-state image sensor device through a plurality of viewingangles within a body cavity formed by said retractor.
 3. The device asclaimed in claim 1, further comprising an illuminating channel connectedto said retractor to illuminate a body cavity formed by said retractor.4. The device as claimed in claim 1, further comprising a suction tubeconnected to said retractor to evacuate smoke produced by anelectrocautery device and accumulated in a body cavity formed by saidretractor.
 5. The device according to claim 1, wherein said solid-stateimage sensor device and said remote display device are connected via acable.
 6. The device according to claim 1, wherein said solid-stateimage sensor device and said remote display device are connected via awireless transmission system.
 7. A device for endoscopically performinga tissue retracting procedure including a retractor having a handleconnected to a shaft connected to a blade to retract tissue, saidretractor having a hollow portion extending through said handle, saidshaft and said blade, said blade having an opening at its distal end, awidth of said opening being equal to a width of said hollow portion,comprising:a solid-state image sensor device connected within a hollowportion of a retractor, to capture images of tissue being retracted bysaid retractor and a body cavity formed by said retractor and to outputa corresponding signal; and a remote display device connected to saidsolid-state image sensor device, to display said images based on saidsignal.
 8. An improved retractor, said improvement comprising:asolid-state image sensor device connected to said retractor, to captureimages of tissue being retracted by said retractor and a body cavityformed by said retractor and to output a corresponding signal; and aremote display device connected to said solid-state image sensor device,to display said images based on said signal.
 9. A surgical retractor andendoscopic device for use within a surgical cavity to both retract bodytissue and view a body cavity being formed by the retracted body tissue,comprising:a retractor including:a shaft having a first end portion anda second end portion; a handle integrally formed to said first endportion of said shaft; a blade integrally formed to said second endportion of said shaft, insertable into an internal organ to retract bodytissue and to thereby form a body cavity; a solid-state image sensordevice connected to said retractor to capture images of tissue beingretracted by said retractor and a body cavity formed by said retractorand to output a corresponding signal; and a remote display deviceconnected to said solid-state image sensor device, to display saidimages based on said signal.
 10. The surgical retractor and endoscopicdevice as claimed in claim 9, wherein said solid-state image sensordevice is connected to said blade of said retractor.
 11. The surgicalretractor and endoscopic device as claimed in claim 9, wherein saidhandle, said shaft and said blade have a hollow portion extendingtherethrough, said blade has an opening at its distal end, a width ofsaid opening being equal to a width of said hollow portion, saidsolid-state image sensor device is connected within said hollow portionof said blade at said opening to permit said image receiving device tosimultaneously receive said images of body tissue; being retracted bysaid blade.
 12. The surgical retractor and endoscopic device as claimedin claim 11, further comprising a knob connected to said solid-stateimage sensor device and said handle of said retractor, to adjustablycontrol a movement of said solid-state image sensor device through aplurality of viewing angles within a body cavity formed by retractingtissue with said retractor.
 13. The surgical retractor and endoscopicdevice as claimed in claim 9, further comprising an illuminating channelconnected to said retractor to illuminate a body cavity formed by saidretractor.
 14. The surgical retractor and endoscopic device as claimedin claim 13, further comprising a suction tube connected to saidretractor to evacuate smoke producing by an electrocautery device andaccumulated in a body cavity formed by said retractor.
 15. The surgicalretractor and endoscopic device as claimed in claim 9, furthercomprising a suction tube connected to said retractor to evacuate smoke;produced by an electrocautery device and accumulated in a body cavityformed by said retractor.
 16. The surgical retractor and endoscopicdevice as claimed in claim 9, further comprising a knob connected tosaid solid-state image sensor device and said handle of said retractor,to adjustably control a movement of said solid-state image sensor devicethrough a plurality of viewing angles within a body cavity formed byretracting tissue with said retractor.
 17. The device according to claim9, wherein said solid-state image sensor device and said remote displaydevice are connected via a cable.
 18. The device according to claim 9,wherein said solid-state image sensor device and said remote displaydevice are connected via a wireless transmission system.
 19. A methodfor endoscopically performing a tissue retracting procedure using aretractor having a handle connected to a shaft connected to a blade,comprising the steps of:providing a solid-state image sensor deviceconnected to a retractor; capturing images of tissue being retracted bysaid retractor and a body cavity formed by said retractor and outputtinga corresponding signal; and displaying said images on a remote displaydevice based on said signal.
 20. A method for endoscopically performinga tissue retracting procedure using a retractor having a handleconnected to a shaft connected to a blade, said retractor having ahollow portion extending through said handle, said shaft and said blade,said blade having an opening at its distal end, a width of said openingbeing equal to a width of said hollow portion, comprising the stepsof:providing a solid-state image device within a hollow portion of aretractor; capturing images of tissue being retracted by said retractorand a body cavity formed by said retractor and outputting acorresponding signal; and displaying said images on a remote displaydevice based on said signal.
 21. A retractor device for retracting andviewing bodily tissues, said retractor device comprising:a blade memberto retract bodily tissues; a solid-state image sensor device connectedto said blade member to produce an image of bodily tissues exposed byoperation of said blade member and to output a corresponding signal; anda remote display device connected to said solid-state image sensordevice to display said image of bodily tissues based on said signal. 22.The retractor device according to claim 21, wherein said solid-stateimage sensor device and said remote display device are connected via acable.
 23. The retractor device according to claim 21, wherein saidsolid-state image sensor device and said remote display device areconnected via a wireless transmission system.
 24. The retractor deviceaccording to claim 23, wherein said wireless transmission systemincludes a transmitter for transmitting signals containing imageinformation related to said image, said transmitter being mounted onsaid retractor device, said wireless transmission system furtherincluding a receiver coupled to said display device for receiving saidsignals and processing said signals so that said image information isdisplayed by said display device.
 25. The retractor device according toclaim 21, wherein said image is digitally processed prior to beingdisplayed by said display device.
 26. A method retracting and viewingbodily tissues, the method comprising the steps of:retracting bodilytissues to form a body cavity; producing an image of a body cavityformed by said retracting step using a solid-state image sensor device;and displaying said image on a remote display device.